结直肠癌合并慢性肾脏病患者术后血清癌胚抗原水平的预后价值。
Prognostic value of postoperative serum carcinoembryonic antigen levels in colorectal cancer patients with chronic kidney disease.
机构信息
Department of Surgery, National Yang-Ming University Hospital, No.169, Siaoshe Rd., Yilan City, Yilan County 26058, Taiwan; School of Medicine, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, 11221 Taiwan.
School of Medicine, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, 11221 Taiwan; Department of Radiology, National Yang-Ming University Hospital, No.169, Siaoshe Rd., Yilan City, Yilan County, 26058, Taiwan.
出版信息
Am J Surg. 2021 Jan;221(1):162-167. doi: 10.1016/j.amjsurg.2020.07.015. Epub 2020 Jul 25.
BACKGROUND
Chronic kidney disease (CKD) can increase serum carcinoembryonic antigen (CEA) levels. We thus aimed to evaluate the impact of CKD on CEA prognostic accuracy in colorectal cancer.
METHODS
Altogether, 429 patients who underwent curative resection for stages I-III colorectal adenocarcinoma were grouped according to postoperative CEA levels and history of CKD.
RESULTS
Three-year disease-free survival (DFS) was higher in patients with normal postoperative CEA (group A, 83.4%) than in those with elevated postoperative CEA (group B, 64.3%) (p < 0.001). CKD patients had higher postoperative CEA levels than non-CKD patients (odds ratio 3.27, 95% confidence interval 1.78-5.99, p < 0.001). In multivariable analysis, postoperative CEA level was an independent prognostic factor for DFS in non-CKD, but not CKD, patients.
CONCLUSIONS
CKD can increase postoperative CEA levels in colorectal cancer patients. Elevated postoperative CEA levels were associated with shorter DFS in non-CKD, but not CKD, patients.
背景
慢性肾脏病（CKD）可使血清癌胚抗原（CEA）水平升高。因此，我们旨在评估 CKD 对结直肠癌患者 CEA 预后准确性的影响。
方法
共有 429 例接受 I-III 期结直肠腺癌根治性切除术的患者，根据术后 CEA 水平和 CKD 病史进行分组。
结果
术后 CEA 正常（A 组，83.4%）患者的 3 年无病生存率（DFS）高于术后 CEA 升高（B 组，64.3%）患者（p<0.001）。CKD 患者的术后 CEA 水平高于非 CKD 患者（比值比 3.27，95%置信区间 1.78-5.99，p<0.001）。多变量分析显示，术后 CEA 水平是非 CKD 患者而非 CKD 患者 DFS 的独立预后因素。
结论
CKD 可增加结直肠癌患者术后 CEA 水平。非 CKD 患者中，术后 CEA 水平升高与 DFS 缩短相关，而 CKD 患者中则无此关联。
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